Heavy alcohol use impacts HIV/AIDS in several important ways. It increases HIV-risk behaviors, impairs the immune system and accelerates HIV and other disease progression, and interferes with HIV care compliance. Women are particularly important targets for alcohol use interventions. Heavy/hazardous alcohol use is less likely to be detected in women in health care settings. The threshold for harmful alcohol effects is strikingly low in women, with two drinks per day placing women at risk for negative health consequences. Also, women may be less likely to seek and engage in alcohol treatment services, making nontraditional care settings particularly important for reaching this population. This proposal tests the utility of a brief alcohol intervention delivered in a medical setting for HIV+ women. Hazardous/binge female drinkers will be identified in the Johns Hopkins Hospital HIV Clinic and will be randomized to brief intervention or standard care. Brief intervention will include four 30-minute contacts delivered by a trained therapist. Outcome measures will include: alcohol/drug use, engagement in a weekly on-site support group or other alcohol treatment services, HIV-risk behaviors, HIV disease markers and treatment compliance, psychiatric symptoms and quality of life. Primary aims are to examine alcohol use, HIV-risk behaviors, HIV treatment compliance and disease progression and quality of life in women receiving the brief intervention compared to women receiving standard care. Secondary aims include: determination of the prevalence of hazardous/heavy drinking in this population; and characterization of the effects of heavy alcohol use on HIV disease progression in women. Brief interventions are being applied in a wide variety of health care settings. This study will provide information on a practical and easily applied intervention for the particularly vulnerable population of HIV+ women.